Hamilton Health Sciences discriminated against cardiac leader based on gender, Tribunal rules
Hamilton Health Sciences (HHS) discriminated against the first woman head of cardiac surgery in Canada, the Human Rights Tribunal of Ontario has ruled.
Dr. Irene Cybulksy complained to the tribunal that gender discrimination was behind her removal in 2016, when she was replaced as leader of the division at Hamilton General Hospital by a male cardiac surgeon.
In her decision dated March 18, tribunal vice-chair Laurie Letheren has concluded there were multiple breaches" of Cybulsky's rights.
One might have expected that having the only female head of cardiac surgery in Canada would be something that a teaching hospital such as HHS would want to celebrate," Letheren states in her decision. Unfortunately, this was not the applicant's experience. The role that her gender played in her experiences in the context of this male-dominated profession was ignored. This resulted in multiple breaches of her rights that as a woman, the (Human Rights) Code is to protect."
Freedom of information documents obtained by The Spectator show HHS spent nearly $850,000 in legal fees as of April 7, 2020, defending itself and its leaders against the claim. HHS did not confirm the final amount.
The decision names present HHS leaders Dr. Michael Stacey and Dr. Helene Flageole. It also names retired leader Dr. Richard McLean, who is a coroner.
A separate process to determine remedies will be scheduled.
I am pleased with the outcome," Cybulsky said in a statement.
She no longer works as a cardiac surgeon at HHS and has left medicine altogether after more than 25 years.
She claimed her career had been destroyed and she'd essentially become a pariah with no hope of ever working in a leadership capacity," in her application to the tribunal on Sept. 5, 2016.
Instead she switched careers and has been attending law school at Queen's University in Kingston.
I hope my actions will help not only other female physician leaders at my (former) workplace, but all physicians," she told the tribunal.
There were 26 days of hearings between 2017 and when the case came to an end on Nov. 14, 2019.
HHS lawyer Raj Anand argued that Cybulsky was replaced because of her adversarial leadership style and inability to serve the best interests of the hospital
We respect the decision by the Tribunal and are reviewing it carefully to ensure we fully understand the Tribunal's reasoning," HHS said in a statement. HHS is deeply proud of the contributions made by women leaders, past and present, to build the clinical programs, research and academic mission of our hospital system. Our organization is guided by core values, including respect and accountability, which will also be applied to the steps we take next in the remediation process, and to ensure all our employees feel valued and are free from discrimination of any kind."
The leaders named could not be reached for comment Monday by The Spectator.
The hearing gave a rare glimpse into the inner workings of a cardiac surgery team dealing with life-and-death issues, big egos and scant resources during Cybulsky's leadership from July 2009 to July 2016.
The applicant and a number of the cardiac surgeons testified about the strain placed on them due to constraints on available beds, available operating room time, funding, and other resources," states the decision. Patients' surgeries often had to be delayed and surgeon's schedules were juggled. This could lead to conflicts among the cardiac surgeons when one surgeon's patient might be moved up the waiting list which resulted in another surgeon's patient being bumped out of an OR slot."
The case painted a turbulent picture of angry outbursts - including one in the middle of heart surgery - as well as rising tensions. There was also an ultimatum from a prominent researcher and heart surgeon that he'd leave if Cybulsky remained as leader.
Cybulksy felt so targeted that she started secretly recording many of her conversations, which were entered into evidence.
The applicant suggested to those in decision-making roles that the stereotypes and bias experienced by women in leadership roles could be impacting her situation," states the decision. The executive vice-president and chief medical executive at HHS acknowledged that the fact that she was a woman and those she was leading were men could be impacting her experiences. Unfortunately, however, the role that her gender played ... was ignored by the respondents ... in each of the instances examined by the Tribunal."
Cybulsky said in her application that her leadership had served as a role model for women" entering the male-dominated surgical fields and that her removal instead served as a warning that gender does matter and the glass ceiling is still there."
The decision called it highly significant" that during Cybulsky's entire career," starting in 1990 as a resident, she was the only female cardiac surgeon at HHS.
In addition to interacting with all male cardiac surgeons, she interacted with interventionists who were all male; cardiac surgery trainees who were all male; ICU attendants who were all male; and that only about a quarter of the anesthesiologists were female," states the decision.
Testimony showed she was an outsider among her colleagues, who bonded in the change room and on a yearly men's ski trip."
Yet, the context of a woman leading a group of men wasn't even considered in a 2014 review of the cardiac surgery service done by Flageole, who is chief of pediatric surgery at McMaster Children's Hospital.
That review was so critical of Cybulsky's communication style - and inability to bond with the surgeons and bring them together as a cohesive group - that parts of it were kept from those working in the division and only seen by hospital leadership. Cybulsky herself wasn't even shown the private sections of the review at first.
Despite the applicant having raised the stereotypes and biases faced by women in leadership and suggesting how these could be working against her in her situation, these factors are never addressed by Dr. Flageole," the decision states concluding she didn't take the allegation seriously.
Dr. Flageole failed to consider all of this in the context of the applicant being a female leader in a very male-dominated workplace."
Cybulsky raised this omission with hospital leaders including McLean, who was executive vice-president and chief medical executive at the time.
It is clear that Dr. McLean recognized that the fact that the applicant was a woman and everyone else in the cardiac surgery service were men could be a factor in what Dr. Flageole had been told by those interviewed," states the decision. However, he did not acknowledge that Dr. Flageole should have considered that context in conducting the review."
As a result, both Flageole and McLean violated Cybulsky's rights, concludes Letheren. In addition, HHS had a duty to ensure that anyone conducting a review of the applicant's leadership, in the context of such a male-dominated workplace, would properly address the role that gender plays in perceptions of women in leadership roles."
Letheren says Cybulsky's dignity was undermined by conclusions which were devoid of any gender analysis and the damage was compounded when those conclusions were accepted by HHS and Dr. McLean, who himself had raised gender as a possible factor."
The assumption ... that gender is not a factor in the development or assessment of leadership styles is not neutral in its effects," says Letheren. It is likely to have a disproportionate impact on women occupying leadership roles in male-dominated workplaces as compared to men."
The review was found to have been relied on when the decision to replace Cybulsky was made by Stacey, who was surgeon-in-chief at the time. He is now executive vice-president academic and chief medical executive.
Stacey told Cybulsky on Sept. 16, 2015, that others would be invited to apply for her leadership position, which was found by Letheren to be another breach of her rights.
Cybulsky made a complaint against Stacey to hospital leadership and again brought up gender discrimination, particularly to the HHS human rights and inclusion specialist, but her claims continued to be ignored.
Letheren concludes HHS had a duty to investigate" Cybulsky's claims that bias against female leaders had played a role in what has been happening in her situation. Failing to do so was another breach.
It adversely impacted the applicant's dignity and self-worth as a woman."
Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com